Læknablaðið - 01.05.2016, Blaðsíða 16

R A N N S Ó K N
224 LÆKNAblaðið 2016/102
Heimildir
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ENGLISH SUMMARY
Introduction: Corticosteroids have been used in preterm infants with
immature lungs to decrease their need for supplemental oxygen and
mechanical ventilation. Whether the benefits of the treatment outweigh
possible adverse effects remains controversial. The main objective
of the study was to evaluate the effects of intravenous and inhalation
corticosteroids on preterm infants’ need for supplemental oxygen and
mechanical ventilation and potential adverse effects.
Material and methods: This was a retrospective cohort study on pret-
erm infants at the Neonatal Intensive Care Unit of Children’s Hospital
Iceland, born between 2000-2014 and treated with intravenous (n=28)
or inhalation (n=30) corticosteroids for immature lung disease. For each
infant receiving steriods one infant who did not receive steriods was sel-
ected as control, matched on gestational age.
Results: There was a significant decrease in the need for supplem-
ental oxygen following intravenous and inhalation corticosteroids
administration, and a significant decrease in the need for mechanical
ventilation following intravenous corticosteroids administration, but
not in controls. Infants receiving intravenous corticosteroids gained
significantly less weight than controls during treatment, but no sign-
ificant difference in weight between groups was found at 35 weeks
postmenstrual age, or in other possible adverse effects such as the
prevalence of cerebral palsy.
Conclusion: Intravenous and inhalation corticosteroids decrease
the need for supplemental oxygen in preterm infants with immature
lung disease and intravenous steriods facilitate earlier weaning from
mechanical ventilation, without significant adverse effects. Therefore, it
seems justifiable in selected cases to use corticosteroids in treatment of
preterm infants with severe immature lung disease.
Postnatal corticosteroids in preterm infants with immature lung disease
Erna Hinriksdóttir1, Hrólfur Brynjarsson2, Þórður Þórkelsson1,2
1University of Iceland, Faculty of Medicine, 2Children´s Hospital Iceland.
Key words: Corticosteroids, preterm infants, chronic lung disease, mechanical ventilation.
Correspondence: Þórður Þórkelsson, thordth@landspitali.is
Lokaorð
Rannsókn þessi leiddi í ljós að gjöf barkstera í æð dregur mark-
tækt úr súrefnisþörf fyrirbura með erfiðan lungnasjúkdóm fyrstu
dagana eftir að meðferð hefst og minnkar jafnframt þörf þeirra
fyrir öndunarvélameðferð, án verulegra aukaverkana. Eina mark-
tæka aukaverkunin sem fram kom var tímabundin skerðing á
þyngdaraukningu barnanna. Teljum við því að til greina komi,
undir sérstökum kringumstæðum, að gefa fyrirburum með erfið-
an lungnasjúkdóm barkstera í æð. Leggjum við til að það sé aðeins
gert ef sýnt er að ekki takist að ná börnunum af öndunarvél nema
gripið sé til þessarar meðferðar. Steragjöf á úðaformi virðist einnig
draga úr súrefnisþörf barnanna án merkjanlegra aukaverkana. Því
kemur einnig til greina að gefa fyrirburum stera á úðaformi undir
vissum kringumstæðum, svo sem til að koma í veg fyrir að börn
með vaxandi súrefnisþörf þurfi á öndunarvélameðferð að halda.